DR. FREDRIK WERTHAM’S excellent chapter on the mosaic.

Test is virtually the first full

statement on the test which has been offered in the American psychological literature. The
following material will be welcomed especially by clinicians who have been intrigued by the test
and by the possibilities of using it in projective test batteries. Dr. Wertham provides an
authoritative statement on the theory behind the test and suggests the conditions that his
experience has indicated when it may be fruitfully used.
From the rich background of his experience in psychopathology Wertham makes
available what we regard as significant comments of value to the whole field of projective
psychology, and it is likely that henceforth the Mosaic Test enjoy wider application by American
clinicians.

The Mosaic Test

TECHNIQUE AND PSYCHOPATOLOGICAL

DEDUCTIONS

Fredric Wertham
Read all the pedants’ screeds and strictures,
But don’t believe in anything
That can’t be told in colored pictures.
HISTORY

Not only drawings and paintings but also productions with mosaic pieces and colored blocks
have been used in an unsystematic way for a long time in the observation of children. Mosaics
have the advantage that they combine fixity of the materials used and flexibility of the design.
Using a set of colored wooden mosaic pieces, Margaret Lowenfeld found that the
designs made with them constituted “a valuable aid in estimating emotional stability,” and that it
was possible “to distinguish between educational and intellectual retardation due to emotional
blocking, and educational and intellectual retardation which arose from inherent mental
defects.” The main diagnostic uses were restricted to emotional disturbances, temperamental
difficulties, formal psychological attitudes, and intellectual deficiencies.
Out of these somewhat primitive formal observations I developed an entirely new method of
analyzing and interpreting mosaics by correlating in a very large numbers of cases the mosaic
designs made by adults and children with definite diagnostic clinical reaction types. The case
material included practically every type of case to be seen in a psychiatric hospital, in patients in
a general hospital needing psychiatric, and in large outpatient clinics: psychoses, neuroses,
somatic and neurological conditions, behavior disorders, criminals, juvenile delinquents, drug
addicts, domestic-relations court cases, and normal controls.
TEST MATERIAL

With almost any kind of set of colored pieces of measure of significant results may be obtained.
The mother of a young boy confined in a mental institution in Canada, having heard of this work
with mosaics, gave him brightly colored small pieces of paper and asked him to make designs
out of them. She pasted them securely to a large piece of a paper in the patterns he had laid out,
and sent them along with her letter about his case. Of course it was not possible to give an
opinion on this basis, but nevertheless it was possible to make a definite diagnosis of
schizophrenia from it, which was letter verified. In this continuing research many different toy
mosaic and experimental sets have been used.
The most satisfactory test set in one used by Margaret Lowenfeld and originally obtained
by her from Czecheslovakia, to which I have added one new piece. Without this new piece the
set is at present commercially available through the Psychological Corporation. One
disadvantage of this set is that it is made of thin plastic material barely adequate for practical
purposes and not fully suitable for research. Having had difficulty in finding the proper wood, I
have had sets constructed out of aluminum with the color baked on in an enamel finish. The
pieces are light in weight, sturdy easily handled, and unbreakable and they do not wear out. The
only disadvantage is their expense.

The pieces are of an inch thick. There are six colors: black, blue, red, green, yellow
and off-white or eggshell. Each color is represented in six shapes, as follows:

Squares: 1 inches on each side. Four pieces of each color.

Diamond-shaped pieces: 1 inches on each side. Eight pieces of each color.

Equilateral triangles: 1 inches on each side. Six pieces of each color.

Triangles: 1 inches on the base, 1 inches on each of the other of two sides. Eight pieces of
each color.

Triangles: of an inch on one side, 1 inches on the second side, 1 inches on the third side.
Twelve pieces of each color.

Oblongs: 1 inches by inch. Twelve pieces of each color.

These pieces are used on a tray that measures 16 inches by 10 inches, having a raised margin
about half an inch wide to keep the blanks from sliding off as they are used.
PROSEDURE

The test should be explained to the subject in a friendly manner, first in general and then
specifically. Children usually like to do the test, but sometimes they think that it is too childish
for them-that they are too old to play with blocks. It has to be explained to them that they can do
it as a sort of game, but that the examiner is serious about seeing and using the result. Adults,
too, sometimes feel that such a simple test is beneath them. It has to be explained to them that
this is a test that looks simple but is really a very useful help in arriving at a proper diagnosis of
the individual’s real trouble. In other words, it is important to have the subject start out in as
good a frame of mind as possible, on the one hand taking it not too lightly, on the other not too
fearfully.

The subject is shown the pieces in a box. The examiner takes out a sample of each shape and
shows it to the subject, and then a sample of each color, explaining that all shapes come in every
color, and every color in each shape. The examiner should not state specially that there are six
shapes and six colors but should just show a sample of each. He should also not name the shapes
or the shapes or the colors.

After the subject has been shown what material he can work with, he is asked to make anything
he wants to on the board before which he is sitting in a comfortable position. He is told that he
may take any number of pieces that he wants, of any shape or any color, and that he may make
anything he wants. When he has made something, he should tell the examiner that he has
finished. He should be reassured that he may take as much time as he wants, that there is no great
hurry, although of course he must finish within a reasonable time. Most subjects catch on very
quickly if the instructions are given clearly, fully, and in a friendly, encouraging spirit.

The examiner should look on while the subject makes the design, but his watching should be
very unobtrusive; and he should do something else (like reading) at the same time, so the patient
can feel free. The verbal responses of the patient while he is making the design-at least the
significant ones-should be taken down and entered on the chart.

Sometimes subjects want to destroy a half-finished or almost completely finished design. The
examiner should not permit the individual to obliterate his original design completely. He can,
however, permit him to change the design and to add to it.

When the subject has finished the design, the examiner should ask in general terms what
he was thinking of when he was making it: What does it represent? What did he want to make?
What does it look like? What was in his mind? Does he like it? What does he think of it? For
example, a person may make a seemingly abstract design composed of five triangles with their
points touching at the center of the figure. If he says that he wanted to make a cross or if,
perhaps, he actually says: “This is a cross,” then the design indicates a very serious disorder in
achieving a configuration or Gestalt. (Diagnostically, this suggests an organic brain disease of
cortical type.) Children often tell elaborate stories of what goes on in a design they have made:
“boats floating on the water,” “smoke coming out of a chimney,” “people in a house,” and so on.

When the design is completed, a life-size record is made of it on paper. This can easily be
accomplished in the following manner: A sheet of white paper the size of the tray is placed on a
table directly in front of the tray that contains the subject’s design. The design itself is not
touched. A corresponding block is taken out of the box and placed on the paper with exactly the
same margin at the side as in the design. A ruler can be used to determine the exact
measurements. The block is then traced with a thin pencil point, and the name of the color
written lightly (so that it can be erased easily) in that area. The same procedure is used for the
remaining blocks in the design and when completed the entire design is colored with crayon as
indicated. Always write on the reproduction which side is the top of the picture, and the name of
the picture as given by the subject.

Often, and especially in a doubtful cases, the test should be repeated in a few days or a
few weeks. Therefore when giving a test the examiner should never explain to the subject what
signs and aspects are of importance for the interpretation.
ANALYSIS OF RESULTS

The interpretation of the mosaics can be made either immediately, from the original tray,
or later from the reproduction recorded on paper.

The Mosaic Test does not give a picture of the dynamic structure of a personality. In this
way it is to be distinguished from the Rorschach Test, which gives a description of personality
expressed in the terminology of the test itself, and which is more or less independent of simple
diagnostic clinical labels. To attempt something like that seems to have been Margaret
Lowenfeld’s original intent.

My method of interpreting mosaics is far more limited and at the same time felt to be
more valid. In thousands of cases in has been found that mosaics represent certain basic or
dominant processes corresponding to definite clinical entities or reaction types. Certain mental
diseases are clearly and definitely revealed by the Mosaic Test. This has been verified in
schizophrenia, for example, in hundreds of cases. I have never seen a patient suffering from a
clear-cut case of schizophrenia make a normal design, nor have I ever seen a definitely normal
person make a clear-cut schizophrenic design. Diamond and Schmale [i] have confirmed the
great validity of these criteria of schizophrenia in a relatively small but evidently very well-
studied number of cases, making use of a slightly different set of mosaics. After the exclusion of
doubtful cases they tabulated their result in “definitely schizophrenic mosaics.”

Gambar

FIGURE 5. Pieces Placed on Tray by Schizophrenic Subject

Definitely Schizophrenic Mosaics

Nonschizophrenia o
Schizophrenia 24
This diagnostic correlation does not cover the whole range of classifiable mental
disorders. It is very clear in schizophrenia or in mental deficiency, less clear in the varieties of
psychoneuroses and in certain types of personality. In reflecting basic or predominant
psychological constellations the mosaics evidently show different levels of the complex structure
of the personality. The Rorschach Test is much more useful and revealing in the study of the
normal and neurotic personality. In my experience with it the Rorschach Test is often-on account
of its very finesse-inconclusive, unreliable, or even misleading for the determination of the
differential-diagnostic question is this a schizophrenic or not? This is also confirmed by
Diamond and Schmale [i], who state: “Particularly in schizophrenic disorders, significant
abnormalities in the mosaic may appear before any single diagnostic or psychological test is
reliably and consistently abnormal.”
White
Yellow
Green
Blue
Red
Black
FIGURE 6. Key to the Mosaic Test Designs

OUTLINE OF CHARACTERISTICS

Despite the limitation of means, the possible variety in mosaic designs is very great.
Empirically, certain characteristics have been singled out that one should have in mind when
evaluating a design. It is of no value, however, to chart these characteristics separately and make
statistical computations. The designs are to be evaluated as a whole. That is the way to realize
their diagnostic significance in relation to typical, formal, clinical-reaction types.
The examiner will do well to accumulate a fairly large amount of case material for
himself. This can be done easily and relatively quickly wherever case material is available. He
can then interpret against the background of the many cases he himself has seen.
In order to learn the method fully the examiner should not limit his own experience only
to children as he may be tempted to do if he works in a child-guidance clinic. To become expert
in the method it is indispensable that from the beginning one also interpret the designs made by
adults because they are so much simpler to interpret, especially in cases with psychoses.
The enumeration of the following characteristics is intended as a scheme which the
examiner should have in mind so that he can give an objective description of the designs. It
should be used in